信任状况与患者就医行为、门诊费用及健康教育需求的相关分析

Correlation analysis between trust status and patients′ medical behavior, outpatient expenses and health education needs

目的 了解不同等级医疗机构患者对医生的信任状况,探索信任状况与患者就医行为、门诊费用及健康教育需求的关系。方法 采用多阶段单纯随机抽样的方法,在上海市黄浦区的一二三级医疗机构中随机抽取878名患者或家属进行问卷调查,调查内容包括人口学特征、就医行为、门诊费用、对医生的信任状况、健康教育需求等。结果 调查对象就诊首选的医疗机构50.1%为市级医院、31.2%为区级医院、21.6%为社区卫生服务中心,就诊首选的医生27.0%为专家门诊医生、51.4%为普通门诊中年长或职称高的医生、21.6%无所谓;调查对象最近一次看门诊的费用平均300元,其中门诊医药费为230元,54.3%的调查对象认为当前的医疗费用较高、37.8%认为一般、1.6%认为较低、6.3%说不清楚;81.0%的调查对象对医生不太信任、19.0%比较信任;调查对象的健康教育需求包括简单的测血压或血糖(29.7%)、定期上门健康咨询和指导(29.6%)、网上或手机咨询(20.4%)、专题防病知识讲座(20.0%)等。结论 信任状况对患者就医行为、门诊费用和健康教育需求有一定的影响,充分发挥健康教育的作用,对提高居民的健康知识、改善医患双方的信任状况有积极的意义。

Objective To understand patients′ trust status to doctors in different levels of medical institutions, to explore the relationships between trust status, patients′ medical behavior, outpatient expenses andhealth education needs. Methods Amulti-stage simple random sampling was employedto select 878 patients or their family members from the primary, secondary and tertiary medical institutions in Huangpu District, Shanghai for a questionnaire survey, including demographic characteristics, medical behavior, outpatient costs, trust status to doctors, health education needs, etc. ResultsFor preferred medical institution, 50.1% of the respondents preferred municipal hospitals, 31.2% preferred district hospitals and 21.6% preferred community health centers. For preferred doctors, 27.0% of respondents preferred to expert outpatient doctors, 51.4% preferred senior doctors in general outpatient, and 21.6% did not have specific preference. The average cost of seeing a doctor at last time was RMB 300,of which the outpatient medical fee was RMB 230. Among the respondents, 54.3% of whichconsidered that the current medical cost was high, 37.8% considered normal, 1.6% considered low and 6.3% did not haveclear consideration.For trust status to doctors, 81.0% of respondents had little trust in doctors, and 19.0% trusted doctors. In terms of health education needs, respondents expressed the needs on simple blood pressure or blood sugar testing(29.7%),regular health consultation and guidance(29.6%),online or mobile consultation(20.4%),and specific lectures on disease prevention(20.0%). Conclusion Trust status affects patients′ medical behavior, outpatient expenses and health education needs, giving full play to the role of health education is of positive significance to improve the residents′ health knowledge and improve the trust between doctors and patients.